In a maternity ward this week, one health worker cradled a tiny newborn as another patted her back and chest to clear her lungs.

The baby, recovering from pneumonia, clung to a furry blanket. She nestled her fluffy, coal-colored head in one of the caregivers’ arms.

This patient was the 17th gorilla born at any of the San Diego Zoo facilities — and the first one delivered in the county by Caesarean section.

Her survival demonstrated the challenges and advances in zoological veterinary medicine, which covers animals from hummingbirds to hippos and draws from a range of specialties including human medicine.

“Very little of what we do is routine or mundane,” said Geoff Pye, senior veterinarian for the San Diego Zoo.

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Around 2 a.m. on March 12, Imani began stirring as other members of her troop slumbered in the gorilla bedroom at Safari Park, said Nadine Lamberski, associate director of veterinary services for the facility.

By the morning, Imani was straining to deliver and keepers noticed that her water might have broken. The zoo’s veterinarians huddled with keepers to draw up a plan.

“We got the call at noon that she was (still) in labor and having contractions, but not progressing,” Lamberski said. “We made the decision to prepare for anesthesia and a C-section, but we were still hoping that she would have the baby” on her own.

Gorilla mothers typically weigh about 200 pounds and deliver babies smaller than five pounds, so their births are usually quick and easy.

“If you think about animals in nature, if they might have a difficult time giving birth — which would put both baby and mother at risk — evolutionarily, that would be a quick dead-end,” said Tom Meehan, vice president of veterinary services for the Brookfield Zoo in Chicago and a member of the animal health committee for the Association of Zoos and Aquariums.

In the wild, experts said, both Imani and her baby probably would have died as the labor extended well past the normal window for gorilla births. At Safari Park, the veterinary team sprung into action.

The C-section is a relatively straightforward procedure — and one that zoo vets routinely perform on hooved animals. But it’s unusual for gorillas, and so the case of Imani raised the stakes for the surgical team.

“Gorillas, as a charismatic animal, it changes things a bit,” Lamberski said. “It’s a high-profile animal, and there’s that human link.”

Zoo veterinarians rely on treatment of more common “prototype species” to inform their practice, said Jeff Zuba, senior veterinarian for the Safari Park. Medical care for domestic cats, for instance, gives insight into care for lions and cheetahs, while sheep and cattle serve as models for treating giraffes and gazelles.

For gorillas, the prototype is human medicine. In recent years, zoo veterinarians have adapted for gorillas procedures ranging from hip replacement to brain surgery. They use cutting-edge imaging equipment including ultrasound, digital X-ray machines and CT scanners.

The veterinary hospital at San Diego Zoo Safari Park, where a baby gorilla was delivered by c-section. Photo courtesy of San Diego Zoo Safari Park

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The veterinary hospital at San Diego Zoo Safari Park, where a baby gorilla was delivered by c-section. Photo courtesy of San Diego Zoo Safari Park

Medical advances in anesthesia equipment and medications are equally important, because zoo veterinarians must immobilize wild animals for even routine exams and blood tests.

“I joke that we test out these procedures in humans to make sure they’re safe, and then use them in gorillas,” said Meehan in Chicago.

But in human medicine, doctors contemplating a C-section could discuss it with the expectant mother, perform fetal monitoring and administer an epidural.

The veterinarians at Safari Park had to practice what they described as “binocular medicine” — observing Imani’s progress from afar. They considered trying ultrasound or fetal monitoring through the gorilla enclosure’s barriers, but ultimately opted against the idea.

When they decided to proceed with the C-section, Imani’s anesthesia had to be administered with a dart gun.

“She wasn’t very happy about that,” he said. “The minute she saw me with the dart pistol and barrel, she started screaming.”

Once Imani was under anesthesia, vets checked the baby’s vital signs and prepped for surgery, assisted by an outside veterinary surgeon and doctors who specialize in treating humans, including an anesthesiologist and a neonatologist from the UC San Diego School of Medicine.

Although the surgery itself went smoothly, the baby gorilla aspirated fluid during the birth and suffered respiratory distress in the following days. Twice, veterinarians had to clear bronchial blockages and reinflate her lungs.

They eased her breathing with a small oxygen mask and prescribed antibiotics to treat the pneumonia.

Gorilla moms carry their infants constantly, so staff members have taken turns holding the newborn.

As her condition improves, zoo officials are planning for her future with the troop. Although she’s a first-time mom, Imani is already a skilled caregiver. Five years ago she helped raise another young gorilla, Frank, who was rejected by his birth mother.

They plan to slowly introduce the baby to the troop. On Friday morning, they brought her to the gorilla enclosure for a “visual introduction” to the other gorillas, who were curious and excited to meet her, said senior keeper Matt Gelvin.

“She’s cute, there’s no doubt about it,” said Don Janssen, the zoo’s corporate director for animal health. “It’s real important for us that these animals grow up and get the proper socialization so they can have a gorilla life, and not a modified human life.”